Antiphospholipid antibodies in women at risk for preeclampsia

被引:70
作者
Branch, DW
Porter, TF
Rittenhouse, L
Caritis, S
Sibai, B
Hogg, B
Lindheimer, MD
Klebanoff, M
MacPherson, C
VanDorsten, JP
Landon, M
Paul, R
Miodovnik, M
Meis, P
Thurnau, G
机构
[1] Univ Utah, Dept Obstet & Gynecol, Salt Lake City, UT USA
[2] Univ Pittsburgh, Dept Obstet & Gynecol, Pittsburgh, PA USA
[3] Univ Tennessee, Dept Obstet & Gynecol, Memphis, TN 38103 USA
[4] Univ Alabama, Dept Obstet & Gynecol, Birmingham, AL 35294 USA
[5] Univ Chicago, Dept Obstet & Gynecol, Chicago, IL 60637 USA
[6] Med Univ S Carolina, Dept Obstet & Gynecol, Charleston, SC 29425 USA
[7] Ohio State Univ, Dept Obstet & Gynecol, Columbus, OH 43210 USA
[8] Univ So Calif, Dept Obstet & Gynecol, Los Angeles, CA 90089 USA
[9] Univ Cincinnati, Dept Obstet & Gynecol, Cincinnati, OH USA
[10] Wake Forest Univ, Bowman Gray Sch Med, Dept Obstet & Gynecol, Winston Salem, NC 27103 USA
[11] Univ Oklahoma, Hlth Sci Ctr, Dept Obstet & Gynecol, Oklahoma City, OK 73190 USA
[12] NICHHD, Bethesda, MD 20892 USA
[13] George Washington Univ, Ctr Biostat, Washington, DC USA
关键词
anticardiolipin antibodies; antiphospholipid antibodies; intrauterine growth restriction; preeclampsia;
D O I
10.1067/mob.2001.113846
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE: The aim of this study was to determine whether positive results of tests for any of 5 antiphospholipid antibodies are associated with recurrent preeclampsia among women with a history of preeclampsia in a previous pregnancy. STUDY DESIGN: Second-trimester serum samples were obtained from 317 women with preeclampsia in a previous pregnancy who were being followed up in a prospective treatment trial. The serum samples were measured by enzyme-linked immunoassay for immunoglobulin G and immunoglobulin M antibodies against 5 phospholipids. Positive results were analyzed with regard to preeclampsia, severe preeclampsia, intrauterine growth restriction, and preterm delivery. RESULTS: Sixty-two of the 317 women (20%) had recurrent preeclampsia develop, 19 (6%) had severe preeclampsia, and 18 (5.8%) were delivered of infants with growth restriction. Positive results of tests for immunoglobulin G or immunoglobulin M antiphospholipid antibodies were not associated with recurrent preeclampsia. Positive results for immunoglobulin G or immunoglobulin M antibodies at the 99th percentile were also not associated with preterm delivery. Positive results at the 99th percentile for immunoglobulin G antiphosphatidylserine antibody were associated with severe preeclampsia, and positive results at the 99th percentile for immunoglobulin G anticardiolipin, antiphosphatidylinositol, and antiphosphatidylglycerol antibodies were associated with intrauterine growth restriction. The positive predictive values for these outcomes all were approximately 30%. CONCLUSION: Positive results of testing for antiphospholipid antibodies in the second trimester were not associated with recurrent preeclampsia among women at risk because of a history of preeclampsia. Positive results for immunoglobulin G antiphosphatidylserine antibody were associated with severe preeclampsia, and positive results for immunoglobulin G anticardiolipin, antiphosphatidylinositol, and antiphosphatidylglycerol antibodies were associated with intrauterine growth restriction. However, the positive predictive values for all these associations were modest. Testing for antiphospholipid antibodies during pregnancy is of little prognostic value in the assessment of the risk for recurrent preeclampsia among women with a history of preeclampsia.
引用
收藏
页码:825 / 832
页数:8
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